Two Sides Take Health Care Debate Outside Washington

President Obama speaking on health care reform in Bristol, Va., on Wednesday. Mr. Obama will be traveling to Elkhart, Ind., partly to sell health care to the public.Credit
Stephen Crowley/The New York Times

WASHINGTON — With Republicans mobilizing against the proposed health care overhaul, President Obama, Congressional Democrats and leading advocacy groups are laying the groundwork for an August offensive against the insurance industry as part of a coordinated campaign to sell the public on the need for reform.

The effort will feature town-hall-style meetings by lawmakers and the president, including a swing through Western states by Mr. Obama, grass-roots lobbying efforts and a blitz of expensive television advertising. It is intended to drive home the message that revamping the health care system will protect consumers by ending unpopular insurance industry practices, like refusing patients with pre-existing conditions.

“I think what we want to communicate is that this is going to give people who have insurance a degree of security and stability, the protection that they don’t have today against the sort of mercurial judgments of insurance bureaucrats,” said David Axelrod, a senior adviser to Mr. Obama, adding, “Our job is to help folks understand how this will help them.”

Revamping health care is the president’s top legislative priority, and people on all sides of the debate agree that August, when lawmakers leave Washington to take the pulse of constituents, will be crucial to shaping public opinion. With Republicans making headway by casting the legislation as a costly government takeover, Democrats have decided they must answer the question on the minds of those now insured: “What’s in it for me?”

That has led to a campaign of increasingly harsh rhetoric against the insurance industry, which says it favors an overhaul but is working to defeat Mr. Obama’s call for a government-run insurance plan to compete against the private sector. On Friday, Speaker Nancy Pelosi, Democrat of California, promised a “drumbeat across America” to counter what she termed a “shock and awe, carpet-bombing by the health insurance industry to perpetuate the status quo.”

The tough talk, however, has risks. The industry trade group, America’s Health Insurance Plans, is urging members to confront Democrats at public meetings, and the rising tensions could make it difficult for the president to keep insurers at the negotiating table.

The drumbeat will begin Monday, when Kathleen Sebelius, the health and human services secretary, travels to Hartford to talk about what the White House now calls “health insurance reform.” Senator Christopher J. Dodd of Connecticut, who disclosed Friday that he has prostate cancer and pointedly reminded Americans that he was fortunate to have health coverage, will be among several Democratic lawmakers present.

Also Monday, Senator Michael Bennet, Democrat of Colorado, will appear with doctors, nurses and administrators at St. Joseph Hospital in Denver to discuss “how insurance company procedures are burdening our physicians, nurses and patients,” a spokeswoman said. Throughout the recess, Democratic lawmakers will hold similar events, coordinated with advertising by allied groups.

“We understand the future of health reform could hinge on how the conversation with the American people goes in the next six weeks,” said Representative Chris Van Hollen, Democrat of Maryland and assistant to the speaker, who is coordinating the House effort.

Republicans understand that and will also be campaigning hard.

In the Senate, Republicans will meet this week to coordinate strategy, but some plans are already in motion for public meetings and a blizzard of radio and television appearances. Senators Tom Coburn of Oklahoma, a family practice doctor, and John Barrasso of Wyoming, an orthopedic surgeon, will take their “Senate Doctors Show,” an Internet program, on the road to argue that the Democratic plan will not improve care or control costs.

In the House, Representative Mike Pence of Indiana, chairman of the Republican Conference, distributed a packet to colleagues on Friday urging them to argue that the Democrats’ plan would include “more than $800 billion in new tax hikes” and “harmful cuts” to Medicare that would “result in millions of seniors losing their health coverage.”

The Democrats are getting a lift from a little-known group of former Obama campaign operatives called Unity ’09 that has held weekly strategy meetings, away from the White House, to bring together administration officials, labor unions, health advocacy groups and other backers of the legislation. Mr. Axelrod said he had attended as an “infrequent visitor.”

The current message is an eight-point list of “Health Insurance Consumer Protections” the White House Web site promises will “bring you and your family peace of mind.” Mr. Obama picked up on the theme last week, promising members of AARP that he would “reform the insurance companies so they can’t take advantage of you.”

The hard line is a departure for the White House, which began its overhaul campaign by trying to win over constituency groups — doctors, pharmaceutical companies, hospitals and insurers among them. Insurers played a leading role in killing a health care overhaul in the Clinton administration, but Karen Ignagni, president of America’s Health Insurance Plans, said at a White House meeting in March that the industry would cooperate this time.

In an interview Friday, Ms. Ignagni noted that the industry had endorsed many of the administration’s proposed changes, including ending the practice of refusing coverage for pre-existing conditions, and said it would work with lawmakers to develop a bill that did not include a public plan.

“The rhetoric that we are hearing is reminiscent of ’93, ’94, but we’re on the 2009 playbook,” she said, adding, “The inconvenient fact is that we support those reforms.”

Republicans say the new rhetoric reflects desperation among Democrats to find a message that will resonate.

Broadly speaking, Mr. Obama’s goal is to extend coverage to the nation’s 47 million uninsured while also slowing the growth of health care spending. The president wanted the House and Senate to pass legislation before the August recess, but the House broke on Friday without doing so and the Senate will not complete a bill before recessing after this week.

Polls show that the public is growing uneasy; a New York Times/CBS News survey last week found that while Mr. Obama still has strong support for revamping health care, Americans are concerned that an overhaul would reduce the quality of care, increase out-of-pocket costs and tax bills and limit their options in choosing doctors.

“August is going to be a critical period for closing the deal,” said Ron Pollack, director of the advocacy group Families USA. The group is now in a strange-bedfellows advertising partnership with the pharmaceutical industry. Their latest advertisement, a three-week, $4 million campaign, updates the “Harry and Louise” advertisements that helped kill health legislation in the 1990s.

In the new advertisement, called “Get the Job Done,” Louise tells Harry that Americans need good coverage. To which Harry adds, “Even if they have a pre-existing condition.”

Carl Hulse contributed reporting.

A version of this article appears in print on , on page A1 of the New York edition with the headline: TWO SIDES TAKE HEALTH DEBATE OUTSIDE CAPITAL. Order Reprints|Today's Paper|Subscribe